Request a Quote - Agents

Please complete the following fields and upload the necessary documents to facilitate the quote process. If you have any questions, please contact Jessica Trosclair, Underwriting Manager, at jtrosclair@lra.org or (504) 636-6532.

Organization *

First Name *

Last Name *

Address Line 1

Address Line 2

City *

State

Postal Code *

Email *

Phone *

Accord

Please upload the accord document.

20MB max

Loss Runs

Please submit 3-5 years of loss runs.

20MB max

NCCI Mod Worksheet

20MB max

Request a Quote - Agents

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